For-Profit Weight Loss Clinics: Are They Dangerous for Patients?

John LaRosa, research director at Marketdata Enterprises, has studied the weight loss industry for over 20 years and estimates that medical weight loss programs, which include those run by hospitals and clinics, bring in $1 billion annually and that the market will grow about 5 percent a year through 2019. The prospects are so lucrative that in March 2015, LaRosa sponsored a seminar advising entrepreneurs how to open their own weight loss clinics.

Most insurance providers reimburse patients for at least a small portion of the bill, thanks to a provision in the federal health care law that requires insurers to pay for nutrition and obesity screening, which has created a financial opportunity for these clinics. But the prospect of rapid growth in the diet clinic industry, fed by those insurance payments, has exposed deep philosophical differences on the best ways to help patients lose weight.

Obesity specialists at major medical centers say the proprietors of diet clinics often employ unproven tactics — including vitamin injections, costly supplements, and extreme diet plans — that lure customers but do not lead to lasting results. Diet clinic owners contend they are filling a needed role because the mainstream medical establishment pays little attention to patients’ struggles with weight.

Sustained weight loss is notoriously difficult to achieve. Lasting results require long-term care and follow-up, said Michael D. Jensen, the director of the obesity treatment research program at Mayo Clinic in Rochester, Minn., who has studied the effectiveness of weight loss programs.

Few clinics follow patients long enough to demonstrate their programs’ effectiveness, although they point to individual success stories and say they do offer comprehensive behavioral counseling. Some are trying to improve treatment standards by employing doctors with backgrounds in obesity and certified nutritionists, while recommending only evidence-based treatments. And they say they offer real options to patients who have been shunned by mainstream medical providers.

But Dr. John Morton, chief of bariatric surgery at Stanford University School of Medicine, said diet clinics should not be the focus of expanded obesity coverage. “Those clinics exist all over the country, and my point about it is we need something better than that,” he said. Even with attentive doctors at the helm, these clinics often employ techniques that are unproven and even some that have been discredited.

Others say tactics like extreme diets and unproven supplements are misleading at best and fraudulent at worst. Michael D. Jensen, Mayo Clinic obesity researcher, studied the effectiveness of weight-loss programs and found that patients who used short-term treatments were not able to keep the weight off.

Many clinics make a profit from selling products to patients, as well as prescription weight-loss drugs like phentermine, which is widely prescribed in diet clinics. And selling medication at a for-profit clinic, whether as part of a package or on its own, still raises red flags for obesity specialists like Jensen. “Clearly, if they’re making money off of it, that’s a conflict of interest,” he said.

Overall, these clinics are becoming more and more popular throughout the United States, but as medical practitioners, we should be wondering how we can step up to help our own patients first before they feel the need to resort to these for-profit clinics.